黄芩饮片临床习用规格的古今文献研究与思考

A review of clinical specifications of Scutellariae Radix pieces in ancient and modern literature

黄芩是一种常用中药,始载于《神农本草经》。在中医药古籍中黄芩被分为子芩(条芩)和枯芩(片芩、宿芩)2种规格入药,而现在的中药相关法规中以黄芩入药,不再区分子芩和枯芩。为了厘清黄芩规格古今演变过程,分析目前其饮片品规是否合理,作者从古籍文献、现代法规及关于子芩与枯芩成分差异、功效差异、转化机制研究等方面对黄芩进行综述。古籍研究发现,古代医家将内实者称为子芩,中空者称为枯芩,且认为枯芩善清上焦之火,子芩主泻下焦之热。现代研究也证明,枯芩与子芩成分差异显著,且子芩主要以结肠为靶器官,而枯芩主要以肺为靶器官,与古籍相关记载吻合。综合古今文献,认为黄芩分为枯芩与子芩具合理性,在临床上能更好发挥其精准治疗作用。

Scutellariae Radix is a commonly used Chinese medicinal first recorded in the Shennong′s Classic of Materia Medica. In the ancient books of traditional Chinese medicine(TCM), Scutellariae Radix is used in two specifications, solid one(Ziqin) and hollow one(Kuqin). In the current rules and regulations of Chinese medicine, Scutellariae Radix is used without the specific requirements for the specifications applied. To clarify the evolution of Scutellariae Radix specifications and analyze the current specifications of Scutellariae Radix pieces, the present study reviews the Scutellariae Radix from ancient literature, modern rules and regulations, and differences between Ziqin and Kuqin in composition, efficacy, and transformation mechanism. According to the research on ancient books, Kuqin is effective in clearing the fire of the upper energizer, and Ziqin in purging the heat of the lower energizer. Modern studies have revealed that Kuqin and Ziqin are significantly different in chemical components, and Ziqin and Kuqin target the colon and lung, respectively, which are consistent with the relevant records in ancient books. The review study suggests that the two specifications of Scutellariae Radix are reasonable since they can facilitate the precise treatment of Scutellariae Radix.